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Supreme Independence Room And Board
Lodging Provider in Detroit, Michigan
NPI 1972267870

Supreme Independence Room And Board is a Lodging Provider based in Sterling Heights, MI. Supreme Independence Room And Board practices in Detroit, MI. The NPI Number for Supreme Independence Room And Board is 1972267870 and holds a License No. (Michigan).

The current practice location address for Supreme Independence Room And Board is 12844 Broadstreet Ave, Detroit, MI and can be reached out via phone at 313-459-9538.

Location: 12844 Broadstreet Ave, Detroit, MI, 48310-7458
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1972267870
Provider Name
Supreme Independence Room And Board
Credential
Provider Entity Type
Organization
Address
12844 Broadstreet Ave, Detroit, MI, 48310-7458
Phone Number
313-459-9538
Fax Number
Provider Enumeration Date
10/26/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
12844 Broadstreet Ave
City
Detroit
State
Michigan
Zip
48238-3250
Phone Number
313-459-9538
Fax Number
person
Provider Business Mailing Address Details
Address
12844 Broadstreet Ave
City
Detroit
State
Michigan
Zip
48238-3250
Phone Number
313-459-9538
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Lodging
Speciality
-
Taxonomy
177F00000X
License No.
()
Definition
A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
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